Blood supply management in times of SARS‐CoV‐2 pandemic – challenges, strategies adopted, and the lessons learned from the experience of a hospital‐based blood centre

Abstract

Introduction Numerous concerns regarding maintenance of blood inventory have been raised after SARS‐CoV‐2 pandemic outbreak. These concerns were based on the experience of blood centres in previous pandemics where shortage of blood components was reported. The present study had tried to understand the impact of SARS‐CoV‐2 pandemic on blood collection and demand as well as the impact of disaster planning in maintaining an adequate inventory. Methods Data related to blood supply and demand were collected retrospectively using blood bank management software for pre‐COVID‐19 and COVID‐19 time period and compared. Strategies adopted and effects of changes in existing disaster plans to maintain an adequate inventory were studied. Results A drastic fall in the red cell inventory was observed as compared to pre‐COVID‐19 time period was observed due to disproportionate decrease in blood collection (1/6 to 1/9 of the previous collection) and demand (1/2 of the previous demand). The buffer stock fell gradually over a period of three weeks with cancellation of planned blood donation drives. A buffer stock equivalent to 2‐week inventory led to adequate inventory in the initial lockdown periods. Similar fall was observed in the platelet inventory with reduction in the blood collection but almost a proportionate reduction in the platelet demand led to adequate inventory. No increase in wastage was observed for both red cells and platelets during this period. Discussion A buffer stock of blood and blood components, strict adherence to the transfusion triggers, good coordination with the clinical staff and a prospective review of blood transfusion requests to ensure rational blood transfusion were some of the steps which helped us to successfully maintain transfusion requirements in the initial phases of the COVID‐19 pandemic. Use of first‐in‐first‐out policy prevented any wastage due to outdating of blood.

Blood shortages and changes to massive transfusion protocols: Survey of hospital practices during the COVID-19 pandemic

“…To ameliorate the ongoing blood shortage, additional strategies have been implemented to reduce blood usage, including prospective auditing of transfusion requests [7], altering red blood cell (RBC) exchange programs for sickle cell patients [8], enforcing and strictly adhering to guidelines for anemia management [9], considering the lowering of transfusion thresholds [10], and various other patient blood management techniques [11].…”

Impact of COVID 19 pandemic on blood transfusion services at a rural based district Hospital Blood-Bank, India

“…Due to the limited shelf life blood and blood components (RBCs, platelets & fresh frozen plasma) acute shortage at the time of crisis as well as discard rate of expired overfilled unused blood products needs to be balanced. 14 The total number of RBCs and platelet stock show a decrease trend following COVID 19 pandemic (Tables 5 and 6). , while discard rate show an upward trend (Figure 2), which is mainly due to the limited shelf-life of platelets.…”

“…M et al 15 Maintenance of buffer stock of blood and blood components along with the ethical issue to blood transfusion recipients and a good co-ordination with clinical staffs ensure a rational blood transfusion. 14 Acute shortage of blood supply in emergency situations can be managed by allocation from neighboring hospital blood banks. During the month of June, to tide over acute crisis, we had borrowed few units of blood from neighbor city Blood bank which is selfexplanatory for the increased number of blood components in the month of June 2020.…”

Measures to reduce red cell use in patients with sickle cell disease requiring red cell exchange during a blood shortage

“…The COVID-19 pandemic has required health care systems to implement strategies for effective delivery of care while managing blood supply disruptions and shortages. 3 14 17 It is recommended that patients with hemoglobinopathies receive red cells prophylactically matched for Rh and K antigens, 8 but the COVID-19 pandemic disproportionately impacted this inventory, underscoring the need for blood saving practices. We report measures that resulted in a large reduction of red cell units transfused to patients with SCD undergoing chronic RCE.…”